Your Fault, My Problem

I'm not one to complain. (I'll wait while you stop laughing. Ready? Ok.) This week, however, I thought it might be interesting for me to share some of the crap I've been having to deal with. As you probably know, I've recently become disabled and been laid off from my job. Being disabled and unemployed puts me in a vulnerable position to say the least. I'm pretty good at sticking up for myself. I've had a lot of practice, but I'm not in top shape right now and would rather not fight battles that don't need to be fought. Unfortunately, the "system" seems to be designed to prevent people like me from getting any kind of help without a fight. There is a lot of paperwork. A LOT. So much that doctors recoil, patients cry, and printers jam.

I was a public school teacher for over 10 years, so I understand being overworked, overstretched, under appreciated, and underpaid. I can sympathize with the doctors and staff when they see a packet of disability paperwork. They know it is going to be tedious and time consuming. They also have other patients to see. So, I can understand how paperwork doesn't always make it to the top of the priority list. The problem is that some people, like me, are depending on that paperwork in order to get the benefits to which they are entitled. (Yes, I said, "entitled." Some of you think that is a bad word, but I've been working and paying into the system since I was 16 years old, so I am entitled to these benefits.) I know that there needs to be a vetting process to deter people from committing fraud, but it shouldn't be so onerous that it also deters the sick people who need the help.

The situation, under the best of circumstances, is clumsy and difficult. It gets worse when someone else makes a mistake along the way. If a doctor or a medical assistant make a mistake on one of those forms, no harm to them. For me, though, it means delays or even starting all over again.

I'm going to give you some examples of how I (the sick person) am now stuck cleaning up someone else's mistakes.

Example #1: Long-Term Disability Insurance

I was lucky that one of the benefits offered to me in my last job was Long-Term Disability Insurance. This was a benefit paid for by the company that would pay me 60% of my salary in the event that I became disabled and unable to work. I never thought I would need this benefit, but I was sure glad it was there when I got sick. After completing the application packet, all I needed was my doctor to sign a form that confirmed that I was unfit to work. I was seeing the ENT most often, so I asked him to do it. He wanted me to pay $25, which was a little annoying, but ok. A week went by and no papers. I called several times to follow up before I got them and they were filled out incorrectly. I made the changes and sent them back. Another two weeks and five phone calls before I got them back and they were still not correct. I finally filled them out myself and sent them back for the doctor's signature. Another week and three phone calls before I got them back and could send them to the insurance company. There were still errors, but after talking to the insurance company they agreed that the claim could continue while those were being corrected.

Meanwhile, they needed medical records from my other doctor. They had sent three requests over the course of two months and had gotten NO RESPONSE. I made an appointment and spoke with the doctor about how important this was. If the insurance company didn't get those records in the next two weeks, they were going to close my claim. He promised to get right on it and sort of chastised me for not letting him handle the whole thing from the beginning since he is my primary care doctor, not my ENT. I felt much better now that he was going to handle the situation. Two weeks went by and the insurance company called to tell me that they had not received the records and were closing my claim. I called the doctor's office and the staff told me that my records were sitting on the doctor's desk. I threatened to come down there and fax them myself if they weren't sent today, and it wouldn't be quietly. I explained in my outside voice that the only thing standing between me and financial ruin was them sending a fax. How hard is it to send a fax? They finally sent the information. This whole ordeal has now taken five months. FIVE MONTHS! That's just to sign a form and fax medical records. Meanwhile, I'm not getting paid.

Example #2: Unemployment

Even though I am disabled and am unable to look for work at this time, I am still required to file an unemployment claim with the Texas Workforce Commission so that when I am able to look for work I can receive unemployment benefits. When I filed my claim, I stated that I was laid off. Then, an inspector from TWC called me to verify my information. He asked for any contact information from my former employer that could verify the layoff and severance payment. I gave him the contact information for my HR contact as well as for my direct supervisor. Apparently, instead of calling either of those people, TWC contacted someone in payroll who told them that I was on a medical leave and not laid off. She didn't know what she was talking about, but now we have a different story than what I told them. Instead of following up with the proper contacts, TWC just decided that I "quit my job because I thought it was harmful to my health." What?? I have no idea where that came from. Now, I have to file an appeal, participate in a hearing, submit copies of documents, blah blah blah, just to correct the record. What a colossal waste of time and resources. How many people are participating in this hearing and how much are they being paid? All of this could have been avoided with a phone call to the correct person. Remember, I'm the sick one. I really should be focusing my energy on getting well. Not trying to convince Texas that, yes I was really laid off.

In both of these examples I have done everything exactly as I was directed, yet other people have messed up along the way and I am left picking up the pieces. It's grossly unfair. They go on with their lives and I'm clinging to survival. You would think in the "greatest nation in the world," that we could do a better job of taking care of those people like me who just need a little help. Instead, we seem to be more worried about keeping people out. It's like if there was a massive blizzard and I had a warm house, but I made everyone stand outside so that I could interview each person one at a time to see if they were worthy to come sit by my fire. That would probably save me from letting a thief into my house by mistake, but the grandma at the back of the line is going to freeze to death before I get to her. Maybe I could let everyone in to enjoy the warmth and just keep an eye on the silver.